The median nerve travels from your forearm into the hand through a small canal or opening in the wrist – “the carpal tunnel”. The bottom and sides of this canal are formed by bones, while the top of the canal is covered by a ligament. Carpal tunnel syndrome occurs when the median nerve is compressed or squeezed as it passes through this opening into the wrist. Trauma or injury may cause an increase in pressure on the nerve as it passes under the ligament in the wrist. Repetitive motions can also lead to swelling in this area. And in some people the carpal tunnel is just smaller than in others.
Regardless of the cause, the symptoms are the same: tingling, numbness, shooting pain, loss of strength or decreased dexterity in the hand and fingers. A common scenario is a person wakes in the middle of the night with numbness in the hand. A shake of the hand and it goes away, allowing the person to go back to sleep. Then at work a few fingers tingle from time to time. The sensations come and go, but eventually become constant with tingling, pain and numbness that become difficult to ignore.
Carpal tunnel syndrome usually begins progressively, that is, it starts with small symptoms that gradually become more noticeable and last longer. It is usually diagnosed based on a person’s presenting symptoms and orthopedic tests. If symptoms are severe, a nerve conduction test can be done to quantify the degree to which the nerve is compromised.
What Can I Do?
Before any therapy begins a person should first try to resolve the symptoms on his or her own. The first line of treatment is to wear a wrist brace or splint at night. Most people flex the wrist while sleeping, which antagonizes the condition. By keeping the wrist straight during prolonged rest there is a better chance of reducing the pressure in the carpal tunnel. While wearing the wrist brace at night a person should also take non-steroidal anti-inflammatory drugs, such as aspirin or ibuprofen to decrease the inflammation that is usually present. At the same time, limit activity and/or repetitive motions of the wrist for at least two weeks. Try these steps for at least 2 weeks to see if the problem resolves itself. If these measures do not decrease or eliminate the symptoms, then a direct intervention is necessary to facilitate healing.
Will acupuncture help?
Acupuncture is often a successful treatment for carpal tunnel syndrome. It aims to decrease the local swelling and inflammation in the carpal tunnel itself, while relaxing the muscles of the forearm. There are several different acupuncture treatments for carpal tunnel syndrome, including local needling, the use of electrical stimulation, moxibustion and distal needling (or needling connected but distant parts of the body). The technique and treatment chosen by an acupuncturist depends on a person’s body type and related circumstances (ex. history of injury, arthritis, circulation, etc.).
Depending on the severity of the symptoms, a person typically receives biweekly acupuncture treatments and often notices an improvement in the first two weeks of treatment. Success with acupuncture depends greatly on a person’s ability to decrease or stop any repetitive motion that may exacerbate the condition while undergoing treatment. This allows the pressure on the median nerve to be eliminated without reintroducing it. Otherwise acupuncture will decrease the symptoms but not adequately treat the source. While individual circumstances influence the length of treatment, acupuncture does successfully treat mild to severe symptoms and has no negative or lingering side-effects.